DIABETES

NEEDS



YOUR GUIDE TO BALANCE CALORIES

PARATHA -200KCAL/ROTI -100KCAL

PULAO - 170KCAL/PLAIN RICE - 160KCAL

FRIED VEGETABLE - 150KCAL/SIMPLE VEGETABLE - 80KCAL

FRIED EGG - 160KCAL/HALF BOILOED - 120KCAL

SOUR CREAM - 210KCAL/YOGURT - 160KCAL

WHOLE MILK - 170KCAL/SKIMMED MILK - 80KCAL


CARBOHYDRATE COMPOSITION


GRAINS (roti, rice, maida, suji, samiya, cornflakes, oats, bajra, jwar, ragi) - 70g/100g

PULSES PULSES (all dals)-56g/100g

VEGETABLE-10g/100g

ROOTS-10-15g/100g

NUTS-5g/100g

MILK-10g/100g -10g/100g


   
CARBOHYDRATE CONTENT IN FOOD ITEMS (in grams)


FOOD         GRAMS OF CARBOHYDRATE AMOUNT
CHEESE BURGER            30 1 med size
MC NUGGETS 15 4 pcs
CHEESE BURGER 30 1 med size
VEGGIE BURGER 30 1 med size
MC FRIES 30 1 small plate
APPLE PIE 25 1 serve
MILK SHAKES 90 200ml
PAN PIZZA 15 1/4 slice
SPHAGHETTI WITH MARINARA    
SAUSE 90 1 quarter plate
GARLIC BREAD 15 1 pc
KFC BREAST 15 1 pc
KFC THIGH 6 1 pc
WHOLE WING 5 1 pc
KFC CHICKEN SANDWICH WITH    
SAUCE 30 1 serve
BHEL PURI 10 1 small plate
CHICKEN CURRY 5 2 pc
FISH CURRY 5 2 pc
BURGER 30 1 med size
FRIED RICE N MANCHURIAN 50 1 quarter plate
CHINESE NOODLES 30 1 quarter plate
CHICKEN LOLYPOP 8 4 pcs
HOD DOG 40 1 med size
VEG GRILLED SANDWICH 40 1 med size
CHICKEN MOMOS 30 4 pcs
THEPLA 15 1 med size
DHOKLA 15 4 pcs
KHANDVI 15 6 pcs
DOSA SAMBHAR 30 1 med size
NACHOS WITH SALSA 30 1 serve
FRENCH FRIES 30 1 small plate
SPHAGHETTI WITH MARINARA    
PASTA 30 1 small plate
GARLIC BREAD 15 1 pc
MAGGIE 30 1 quarter plate
SPROUTS 15 1 med bowl
BESAN CHILA 10 1 med size
PARATHA 30 1 med size
BREAD OMLETTE 20 1 serve
BHEL PURI 10 1 small plate
CUSTARD 15 1 serve
SWEETS 15 1 serve
ICE CREAM 15 1 scoop
CHOCOLATE 15 3 pcs
GULABJAMUN 15 1 pc
WHITE RASGULLA 15 1 pc
    2 serving
RICE 15 spoons
BROWN BREAD 15 1 pc
VEG POHA 15 1 small plate
VEG UPMA 15 1 small plate
MILK 12 200 ml
OATS(MILK) 15 1 cereal bowl
WHEAT FLAKES(MILK) 15 1 cereal bowl
NACHOS WITH SALSA 30 1 serve
DALIA 15 1 cereal bowl
PASTRY 15 1 med size
CURD 2 1 small bowl
DAL 15 1 med bowl
ARBI VEG 20 1 serving
ALOO VEG 20 1 serving
ROTI MEDIUM SIZE 15 1
CLEAR SOUP 30 1 Soup Bowl
SWEET CORN SOUP 15 1 soup bowl
BHEL PURI 10 1 small plate
VEG THALI 80 1 serve each
NON VEG THALI 80 1 serve each
PURI 15 1 med size
COLD COFFEE 11 200 ml
GROUNDNUT ROASTED 15 1 small bowl
ALMONDS 3 5-6 no
WALNUTS 15 2-3 no
FIGS 3 2 no
COCONUT WATER 8.8 200 ml
APPLE 15 1 med size
BANANA 20 1 med size
MANGO 17 1 med bowl
GUAVA 10 1 med size
PEAR 10 1 med size
PINEAPPLE 15 3 slices
STRAWBERRY 10 6 pcs
MARIE BISCUIT 15 1and 1/2
CREAMCRACKER BISCUIT 15 2 no
KRACKJACK   2 no
FRUIT JUICE 15 200 ml
BEER NON ALCOHOLIC 15 150 ml
SODA BEVERAGES 15 150 mll


CARBOHYDRATE EXCHANGES

1 carbohydrate exchange = 15 g carbohydrate

1 starch/cereal exchange (15 g)

1 legume exchange (15 g)

1 fruit exchange  (15 g)

1 milk exchange  (12 g)

1 vegetable exchange  (5g)


Example: 1 katori whole pulse = 1 glass milk = 1 small banana = 1small katori rice
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CARBOHYDRATE COUNTING



Method 1

FOOD DIARY, INSULIN DOSE, AND SMBG INFORMATION

Insulin: Carbohydrate ratio = Grams of carbohydrate at a given meal ÷ number of units of insulin taken at that meal

EXAMPLE:

1. Patient needs 4 units of insulin to cover 40 grams of carbohydrates


2. Insulin: Carbohydrate ratio = 40 ÷ 4 = 10 Ratio = 1:10 (This means that 1 unit of rapid acting insulin is needed for every 10gms of carbohydrate in a meal)


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Method 2


THE RULE OF 500/300

Insulin: Carbohydrate ratio = 500/300 ÷ total daily insulin dose of insulin (TDD)


EXAMPLE:

• TDD = 36 units Glucose levels are within target range

• Insulin: Carbohydrate ratio = 500 ÷ 36 = 13.8 (round up to 14) Ratio = 1:14

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Method 3


USING THE INSULIN SENSITIVITY FACTOR (ISF)

• ISF = 1700÷ Total Daily Dose of Insulin(TDD) • Insulin: Carbohydrate ratio = ISF× 0.33 TDD

EXAMPLE:

• ISF = 1700 ÷ 25 = 68 mg/dl

• Insulin: Carbohydrate ratio = 68 × 0.33= 22.4 (round up to 22)

DETERMINING PREMEAL INSULIN DOSE

EXAMPLE:

• TDD= 34 units

• Target glucose levels = 100 mg/dl

• Premeal glucose level = 226 mg/dl

• 60 grams of carbohydrates are to be consumed

ANSWER

• ISF = 1700 ¸ 34 = 50

• Difference between target and actual glucose levels = 226 – 100 =126 mg/dl

• Correction dose = 126 ÷ 50 = 2.3 units

• Insulin : carbohydrate ratio

• 500 ÷ 34 = 14.7

• Ratio= 1:15

• Units of insulin to cover carbohydrates = 60 ÷ 15 = 4 units


Premeal insulin = 2.3 units + 4 units = 6.3 units

RATIO - 1:22


INSULIN DOSE CORRECTION

EXAMPLE:

• Glucose = 264mg/dl

• Target glucose level is 100 mg/dl

• ISF = 53 mg/dl

ANSWER

• Difference between target and actual glucose levels = 264 – 100 = 164 mg/dl

• Correction dose = 164 mg/dl ÷ 53 mg/dl = 3.1 units

The correction dose of insulin is 3 units


BASIC PRINCIPLES OF DIABETIC DIET



• HIGH FIBER (e.g. green leafy vegetables, fruits and salad)

• LOW FAT (3-4 tsp/day)

• MEALS ON TIME

• SPLIT YOUR MEALS

• TAKE SIX SMALL AND FREQUENT MEALS

• HEALTHY ROASTED AND NON FRIED SNACKS – mid morning and mid afternoon

• NO DIRECT SUGARS - sugar, honey, jaggery, jam, jellies

• CHOOSE HEALTHIEST DIET WHEN EATING OUT (FEASTING) (no maida, sweets and fried foods)

• MEALS ON TIME

• DRINK LOT OF WATER




• REFINED FLOUR PRODUCTS

• SWEETS

• FRIED FOODS

• SKIPPING OF MEALS

• FASTING

• FREQUENT FEASTING


Remember diabetes is not a disease…….. ……… it is a condition, we can manage!!


NUTRITION LABELS


Sugar free foods

These foods have less than 0.5 grams of sugar per serving. However sugar free does not mean carbohydrate free

No sugar added

Foods do not have any kind of sugar added during processing or packaging, and do not contain high sugar ingredients. But remember they may still be high in carbohydrate, so you have to check the label.

Fat Free

Foods are often higher in carbohydrate than the foods they replace, so they are not a better choice.


ARE YOU CONFUSED?

Visit the nutrition and diabetes column.

Shweta Singh
Nutritionist and Diabetes Counselor
(M. Sc. Foods and Nutrition, CDE).